Kristi Boggs
Seminole,OK
Summary
Dedicated healthcare professional with over 33 years of diverse nursing experience, committed to delivering compassionate and effective patient care. Proven expertise in critical thinking, patient assessments, and care coordination ensures optimal outcomes in dynamic environments. Strong advocate for collaboration and communication within teams, fostering trust and support among patients and colleagues. Actively engaged in community service, particularly focused on assisting vulnerable populations, demonstrating a genuine passion for making a positive impact both professionally and personally.
Overview
35
35
years of professional experience
Work History
RN Medical Case Manager
HCSC/Blue Cross Blue Shield of Oklahoma
03.2015 - Current
- Remote Home Office/Independent worker
- Daily Telephonic Medical Case Management of all levels of care-Patient advocacy
- Provide patient and provider education
- Facilitate member access to community-based services
- Monitor referrals made to community-based organizations, medical care and other services to support the members’ overall care management plan
- Actively participate in integrated team care management rounds weekly and PRN
- Identify related risk management quality concerns and report these scenarios to the appropriate resources
- Chronic Condition Management, Care Planning
- Medical/clinical review
- Behavioral health assessment, counseling, co-manage with BH CM team when necessary and or if further resources needed
- Quality of Care, Review, Coordination
- Review & maintain approximately 50 active cases weekly
- Research, causation & review justification of applicable medical treatment
- Special Projects as needed/requested
- Direct Member care to In-Network providers
- Behavioral health outreach, support, skills, referrals as needed
- Excellent documentation and communication skills
- Assessment, Diagnosis, Planning, Intervention, Evaluation for all levels of care
- Daily, weekly, PRN Medical Director case/collaboration
- PC proficient (Microsoft Word, Excel, Outlook, PDF, Microsoft Teams) 100+ WPM
RN-Field/Telephonic Medical Case Manager/Worker’s Compensation-Insurance
KC's Case Management Services, LLC
01.2007 - 03.2015
- Worker’s Compensation Field/Telephonic Medical Case Management/all levels of care for injured workers
- Leadership
- Assessment, Diagnosis, Planning, Implementation, Evaluation for all aspects of Nursing
- Liaison/Advocate
- Care planning, care coordination/transition for all levels of care
- Auditing/review
- Medical care coordination for injured workers
- Behavioral Health assessment, counseling, coordination
- Pre-certification Assessment/coordination PRN
- Discharge Planning/Community referrals
- Utilization, Medical File & QA review
- Multiple in-person/verbal consultations with all parties involved in a claim (Physician’s, Injured Worker’s, Employers, Insurance companies/adjusters)
- Physician Collaboration
- Medical education/teaching to injured workers, adjusters, employers
- Research-utilization of Official Disability Guidelines
- 70% Travel
- Computer: Data Entry-Microsoft Word, Excel, Outlook, QuickBooks
- Marketing
RN/CM-Field & Telephonic Medical Case Manager-Worker’s Compensation
GENEX Services, Inc
01.2003 - 01.2007
- Worker’s compensation Field & Telephonic Case Management various insurance agencies, injured workers, employers
- All duties as listed above
- 60-80hr/work weeks
RN-In House Telephonic Medical Case Manager/Workers' Compensation Case Manager
CORVEL Corporation (Wal-Mart)
01.2000 - 01.2003
- In-House telephonic medical case management of injured employees/worker's compensation (various states)
- Care planning, care coordination/transition for all levels of care
- Mental health management, assessments, referrals, intervention
- Follow state specific guidelines (various states covered)
- Utilization Review
- Pre-Certification
- File Review
- Coordination of data for all exams
- Data Entry-Microsoft Word, Excel, Outlook
- Supervisory duties
- Daily Education/Medical Research for insurance adjusters
ADON Skilled Unit Manager-Wound Care CM/RN SNF-LTC
Heritage Villa
02.1998 - 01.2000
- Assistant Director of Nursing/Employee supervision, staffing
- House Wound Care Supervisor/Coordinator
- Skilled Nursing Facility/Rehab Supervisor
- Management of multiple mental health patients
- Assessment, Diagnosis, Planning, Implementation, Evaluation for all levels of care
- Patient/Family education & support
- In-take coordinator/Admissions
- Marketing
- Discharge Planning
- QA/File Review
RN-Medical Case Manager
Carter Home Health/Hospice
01.1995 - 01.1997
- Basic RN/CM Home Health/Hospice-various Nursing duties
- Aide/LPN Supervisory visits
- Medication Administration
- IV starts/administration-venipunctures
- Care planning
- Patient Admissions
- Mental health management, assessments, referrals, intervention
- Comfort care, family support
- Frequent Travel throughout region
RN staff nurse/QA-Billing Auditor
Americare Home Health
01.1993 - 01.1994
- CM/Billing/auditing of all medical files
- Basic field RN duties
- Quality Assurance provided for all patient files
- Develop Care plans
- All IV management/venipunctures
- Patient Admissions
- Mental health management, assessments, referrals, intervention
- HHA/LPN Supervisor
- Discharge planning
- Frequent Patient/Family counseling, teaching
- BH assessments, referrals, intervention
RN-Staff RN/Charge Nurse
Midwest City Regional Hospital
05.1991 - 01.1993
- Nursing/training
- Basic RN duties-Cardiac/Telemetry, ICU, PICU
- Charge Nurse Telemetry & Women's Surgery
- Staff floor nurse-basic nursing duties
- BH referrals/assessments
- Discharge planning
- Medication administration
- Patient and Family teaching/counseling
Education
Associates Degree - Nursing
Seminole State College
01.1992
Skills
- Patient assessments
- Patient education and counseling
- Clinical judgment
- Patient and family advocacy
- Patient care
- Compassion and empathy
- Patient management
- Care plan development
- Professional bedside manner
- Patient care planning
- Patient evaluation
- Family education
- Licensed RN
- Intake and discharge
- High level of autonomy
- Relationship building
- Documentation and charting
Languages
English
Full Professional
Timeline
RN Medical Case Manager
HCSC/Blue Cross Blue Shield of Oklahoma
03.2015 - Current
RN-Field/Telephonic Medical Case Manager/Worker’s Compensation-Insurance
KC's Case Management Services, LLC
01.2007 - 03.2015
RN/CM-Field & Telephonic Medical Case Manager-Worker’s Compensation
GENEX Services, Inc
01.2003 - 01.2007
RN-In House Telephonic Medical Case Manager/Workers' Compensation Case Manager
CORVEL Corporation (Wal-Mart)
01.2000 - 01.2003
ADON Skilled Unit Manager-Wound Care CM/RN SNF-LTC
Heritage Villa
02.1998 - 01.2000
RN-Medical Case Manager
Carter Home Health/Hospice
01.1995 - 01.1997
RN staff nurse/QA-Billing Auditor
Americare Home Health
01.1993 - 01.1994
RN-Staff RN/Charge Nurse
Midwest City Regional Hospital
05.1991 - 01.1993
Associates Degree - Nursing
Seminole State College